OBJECTIVES: Patients colonized with multidrug-resistant organisms, especially Methicillin resistant Staphylococcus aureus (MRSA), impose a risk on other patients and on healthcare professionals. In addition, they will suffer from substantial health problems when getting an infection. This contribution examines the incentives of German rehabilitation centers to implement screening strategies to stem nosocomial infections and the spread of MRSA. METHODS: Relying on a decision tree analysis, the expected healthcare cost per capita is calculated for three strategies: (i) general screening, (ii) risk-based screening, both on admission, and (iii) no screening at all. Parameters are taken from the published literature. To handle uncertainty, multivariate sensitivity analyses are performed. RESULTS: From the perspective of a rehabilitation center, the third strategy yields the lowest expected cost while the first one causes the highest cost. This ordering is robust with respect to sensitivity analysis. Thus, cost savings due to a lower number of MRSA infections are not sufficient to offset the cost of the test and further prevention measures applied to individuals with a positive result. CONCLUSIONS: In Germany, rehabilitation centers are reimbursed by daily rates. In particular, they receive no extra fees for prevention measures. As our analysis demonstrates, this implies the incentive to implement MRSA screening to be too weak. Hence, MRSA prevention measures that would be beneficial to society will not be undertaken. However, our results can be used to indicate changes in the remuneration system that would provide rehabilitation centers with an appropriate incentive for MRSA prevention. Moreover, hygiene regulations enacted very recently (MedHygVO), in the light of our analysis, can be interpreted in a similar manner due to the requirement of a stricter hygiene regimen.